One of the biggest issues of ankylosing spondylitis is how long it takes to be sure you’ve actually got it. The problem is that, in its early stages, ankylosing spondylitis symptoms can look like a range of less-serious issues. It’s all too easy to put that little bit of back pain down to yesterday’s heavy bag or last night’s awkward sleeping position.
There is no one test to confirm the presence of AS. Blood tests or an MRI scan can help your doctor get closer to a diagnosis but these are unlikely to be carried out during a routine health check. So how can you tell if those aches and pains could be more than they seem?
Dr Shashank Akerkar, Consultant Rheumatologist and regular This AS Life contributor, has created a video and shared some questions below for anyone worried that their back pain might be AS:1
Video created by Dr S Akerkar1
We’re all a little bit creaky when getting in or out of bed. However, if you’re still feeling stiff more than 30 mins after getting up or are being kept awake by
your back pain, both are warnings worth paying attention to.
AS pain comes from your joints stiffening up. With this in mind, although it’s very tempting to rest your aches, sitting still may just cause you to freeze up even more. It’s the reason that your backache will tend to be worse just after getting up but will settle down once you’ve been up and about for a bit.
If the key to relieving your pain isn’t putting your feet up but getting them moving again then it could be AS-related.
If you find yourself shifting around a lot when working or watching TV, don’t assume it’s the chair that’s uncomfortable. AS often causes inflammation in the sacro-iliac joints (the places where your legs attach to your pelvis) and this pain can be felt in the muscles around them.3
Visible swelling in joints such as the knees and ankles may be one of the clearest early signs of AS. Similar swelling will be seen in the heel where tendons or ligaments attach to the skeleton. This is a condition known as enthesitis and is a key feature of AS.
Swelling may also affect entire fingers or toes, a feature known as dactylitis or ‘sausage digit’ (which should give you a pretty clear idea of what to look for).
If you’re on the lookout for AS, you’ll probably be alert for back problems but there are other, seemingly-unrelated, conditions associated with an increased risk. These include:
It’s not just the state of your health that could provide clues to the presence of AS. A family history of the condition itself is a clear sign but it’s also worth looking for related conditions in your family tree.
The associated conditions talked about in the previous question have genetic links to AS so, even if you don’t have them, the fact that your dad or your grandma – even your uncle – does could still point to an increased risk of AS.4
Facing the possibility of an AS diagnosis is obviously a scary prospect. However, the earlier you spot it, the earlier you can tackle it and the less power it’ll have over you. If you’re experiencing any of the symptoms we’ve talked about, take control early and speak to your doctor.
Once you’ve got an appointment set, there are a few things you can do to prepare, helping your doctor get to the root of the problem as quickly as possible:
To provide some guidance as to whether you might have ankylosing spondylitis, you can also visit one of the following sites:
Want more tips on talking to your doctor about AS? Why not also check out our article by Dr Ronan Kavanagh on making the most of your appointment?
If your appointment results in an AS diagnosis, start your journey on the right foot with Dr Philip Robinson’s top ten patient must-knows.